Readjudicate FHIR Resource Proposal

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Readjudicate

Owning committee name

Financial Management

Contributing or Reviewing Work Groups

  • Claims with Attachments
  • Patient Administration

FHIR Resource Development Project Insight ID

994

Scope of coverage

The Readjudicate resource indicates the claim which is to be reversed and provides both supporting information for the reversal and the goods and services which are to be readjudicated.


RIM scope

InvoiceElementGroup (classCode=INVE,moodCode=RQO)

Resource appropriateness

This is necessary for the limited supporters who require the ability to formally request the readjudication of specified service subtrees from an already adjudicated Claim.

Expected implementations

This is a new resource to support this infrequently mandated ability to readjudicate claims.

Content sources

Saudi Arabia requirements.

Example Scenarios

Resource Relationships

Refers to a Claim resource and uses Organization, Practitioner. Is referred to by a ClaimResponse.

Timelines

Ready for DSTU 2

gForge Users

paulknapp

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